Unexpected pulmonary mechanics during positive pressure mechanical ventilation in fibrotic lung disease with concomitant flail chest. (2023)

• Record Type: Journal Article
• Authors: Gayen, Shameek; van der Rijst, Nathalie; D'Alonzo, Gilbert; Salerno, Daniel
• Is Part Of: Respiratory medicine case reports. Volume 41(2023)
• Publication Date: 2023
• Subjects: Flail chest -- Chest wall compliance -- Lung compliance -- Respiratory system compliance -- Pulmonary mechanics; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2022.101802
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: Understanding of pulmonary mechanics is essential to understanding mechanical ventilation. Typically, clinicians are mindful of peak and plateau pressures displayed on the ventilator and lung compliance, which is decreased in lung disease such as idiopathic pulmonary fibrosis (IPF). Decreased lung compliance leads to elevated peak and plateau pressures. We present a patient with IPF undergoing mechanical ventilation after cardiac arrest. Despite low lung compliance, he had normal peak and plateau pressures due to the presence of flail chest and increased chest wall compliance. This case highlights the role chest wall compliance plays in total respiratory system compliance and pulmonary mechanics.